Awareness and preparedness of healthcare workers against the first wave of the COVID-19 pandemic: A cross-sectional survey across 57 countries.

BACKGROUND: Since the COVID-19 pandemic began, there have been concerns related to the preparedness of healthcare workers (HCWs). This study aimed to describe the level of awareness and preparedness of hospital HCWs at the time of the first wave. METHODS: This multinational, multicenter, cross-sectional survey was conducted among hospital HCWs from February to May 2020. We used a hierarchical logistic regression multivariate analysis to adjust the influence of variables based on awareness and preparedness. We then used association rule mining to identify relationships between HCW confidence in handling suspected COVID-19 patients and prior COVID-19 case-management training. RESULTS: We surveyed 24,653 HCWs from 371 hospitals across 57 countries and received 17,302 responses from 70.2% HCWs overall. The median COVID-19 preparedness score was 11.0 (interquartile range [IQR] = 6.0-14.0) and the median awareness score was 29.6 (IQR = 26.6-32.6). HCWs at COVID-19 designated facilities with previous outbreak experience, or HCWs who were trained for dealing with the SARS-CoV-2 outbreak, had significantly higher levels of preparedness and awareness (p<0.001). Association rule mining suggests that nurses and doctors who had a 'great-extent-of-confidence' in handling suspected COVID-19 patients had participated in COVID-19 training courses. Male participants (mean difference = 0.34; 95% CI = 0.22, 0.46; p<0.001) and nurses (mean difference = 0.67; 95% CI = 0.53, 0.81; p<0.001) had higher preparedness scores compared to women participants and doctors. INTERPRETATION: There was an unsurprising high level of awareness and preparedness among HCWs who participated in COVID-19 training courses. However, disparity existed along the lines of gender and type of HCW. It is unknown whether the difference in COVID-19 preparedness that we detected early in the pandemic may have translated into disproportionate SARS-CoV-2 burden of disease by gender or HCW type

Safety and efficacy of fluoxetine on functional outcome after acute stroke (AFFINITY): a randomised, double-blind, placebo-controlled trial

Background Trials of fluoxetine for recovery after stroke report conflicting results. The Assessment oF FluoxetINe In sTroke recoverY (AFFINITY) trial aimed to show if daily oral fluoxetine for 6 months after stroke improves functional outcome in an ethnically diverse population. Methods AFFINITY was a randomised, parallel-group, double-blind, placebo-controlled trial done in 43 hospital stroke units in Australia (n=29), New Zealand (four), and Vietnam (ten). Eligible patients were adults (aged ≥18 years) with a clinical diagnosis of acute stroke in the previous 2–15 days, brain imaging consistent with ischaemic or haemorrhagic stroke, and a persisting neurological deficit that produced a modified Rankin Scale (mRS) score of 1 or more. Patients were randomly assigned 1:1 via a web-based system using a minimisation algorithm to once daily, oral fluoxetine 20 mg capsules or matching placebo for 6 months. Patients, carers, investigators, and outcome assessors were masked to the treatment allocation. The primary outcome was functional status, measured by the mRS, at 6 months. The primary analysis was an ordinal logistic regression of the mRS at 6 months, adjusted for minimisation variables. Primary and safety analyses were done according to the patient's treatment allocation. The trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12611000774921. Findings Between Jan 11, 2013, and June 30, 2019, 1280 patients were recruited in Australia (n=532), New Zealand (n=42), and Vietnam (n=706), of whom 642 were randomly assigned to fluoxetine and 638 were randomly assigned to placebo. Mean duration of trial treatment was 167 days (SD 48·1). At 6 months, mRS data were available in 624 (97%) patients in the fluoxetine group and 632 (99%) in the placebo group. The distribution of mRS categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio 0·94, 95% CI 0·76–1·15; p=0·53). Compared with patients in the placebo group, patients in the fluoxetine group had more falls (20 [3%] vs seven [1%]; p=0·018), bone fractures (19 [3%] vs six [1%]; p=0·014), and epileptic seizures (ten [2%] vs two [<1%]; p=0·038) at 6 months. Interpretation Oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and epileptic seizures. These results do not support the use of fluoxetine to improve functional outcome after stroke

Chemical fingerprint analysis for quality assessment and control of Curcuma longa L. rhizomes from Vietnam using a high-performance liquid chromatography-diode array detector (HPLC-DAD)

Turmeric, extensively cultivated across Southeast Asia, especially in Vietnam, harbors active polyphenols, primarily curcumin (2–5%), renowned for its diverse health benefits. Pharmacopoeias recognize turmeric, yet it lacks standardized quality assessments and encounters challenges in extraction and identification due to natural variations and adulteration. This analytical method is vital for verifying the authenticity, purity, and quality of turmeric products in both the pharmaceutical and nutraceutical industries. This study successfully developed an efficient extraction process for curcumin (CUR), demethoxycurcumin (DMC), and bisdemethoxycurcumin (BDMC) from Curcuma longa L. rhizomes. The herbal powder was extracted with methanol (1:30, w/v) by the ultrasound-assisted method for 10 minutes, and this process was repeated three times. A high-performance liquid chromatography-diode array detector (HPLC-DAD) method was validated for the simultaneous quantification of three analytes, following the AOAC guideline and achieving a correlation coefficient (R2) value greater than 0.9950. Utilizing the HPLC-DAD method, the study developed a chemical fingerprint analysis for three analytes to identify the characteristic chemical components distinguishing turmeric from each region. Nineteen samples collected from various provinces across Vietnam were subjected to analysis. In all analyzed samples, the concentrations of CUR, DMC, and BDMC ranged from 0.77–10.30%, 0.33–6.92%, and 0.03–3.23%, respectively. CUR was determined to be the dominant compound in most samples, while BDMC consistently exhibited the lowest levels of content. Utilizing the findings derived from the analysis of RRT and RPA metrics, the research assessed variances across sample batches. It is suggested that this newly established approach can be applied to construct and develop raw material areas to serve the needs of each field

Microencapsulation of Lemongrass (Cymbopogon citratus) Essential Oil Via Spray Drying: Effects of Feed Emulsion Parameters

The purpose of this study was to attempt the encapsulation of lemongrass (Cymbopogon citratus) essential oil utilizing spray drying technique. An array of process parameters including concentration of wall (15&ndash;30%), type of wall materials (maltodextrin, maltodextrin and gum Arabic mixture), and concentration of essential oil (0.5&ndash;2.0%) were thoroughly investigated. The results show that the use of sole maltodextrin as encapsulant gave microcapsules characteristics comparable to that of powder produced using maltodextrin and gum Arabic mixture. The encapsulation process that was performed with maltodextrin at the concentration of 30% as wall material and lemongrass essential oil at the concentration of 1.5% as core material showed highest drying yield (84.49%), microencapsulation yield (89.31%) and microencapsulation efficiency (84.75%). Encapsulated essential oils retained most of their major constituents in comparison with the bare essential oils without any significant compromise in product quality

Proceedings of the 5th Conference on Language Teaching and Learning

This conference proceedings contains articles on the various research ideas of the academic community and practitioners presented at the 5th Conference on Language Teaching and Learning (LTAL-2023). LTAL2023 was organized by the Ho Chi Minh City University of Food Industry, Vietnam on May 7, 2023. Conference Title: 5th Conference on Language Teaching and LearningConference Acronym: LTAL-2023Conference Date: 7 May 2023Conference Location: VietnamConference Organizers: Ho Chi Minh City University of Food Industry, Vietnam. Related Proceedings:  Proceedings of the 4th Conference on Language Teaching and Learnin

Twelve-Month Outcomes of the AFFINITY Trial of Fluoxetine for Functional Recovery After Acute Stroke: AFFINITY Trial Steering Committee on Behalf of the AFFINITY Trial Collaboration

Background and Purpose: The AFFINITY trial (Assessment of Fluoxetine in Stroke Recovery) reported that oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and seizures. After trial medication was ceased at 6 months, survivors were followed to 12 months post-randomization. This preplanned secondary analysis aimed to determine any sustained or delayed effects of fluoxetine at 12 months post-randomization. Methods: AFFINITY was a randomized, parallel-group, double-blind, placebo-controlled trial in adults (n=1280) with a clinical diagnosis of stroke in the previous 2 to 15 days and persisting neurological deficit who were recruited at 43 hospital stroke units in Australia (n=29), New Zealand (4), and Vietnam (10) between 2013 and 2019. Participants were randomized to oral fluoxetine 20 mg once daily (n=642) or matching placebo (n=638) for 6 months and followed until 12 months after randomization. The primary outcome was function, measured by the modified Rankin Scale, at 6 months. Secondary outcomes for these analyses included measures of the modified Rankin Scale, mood, cognition, overall health status, fatigue, health-related quality of life, and safety at 12 months. Results: Adherence to trial medication was for a mean 167 (SD 48) days and similar between randomized groups. At 12 months, the distribution of modified Rankin Scale categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio, 0.93 [95% CI, 0.76–1.14]; P =0.46). Compared with placebo, patients allocated fluoxetine had fewer recurrent ischemic strokes (14 [2.18%] versus 29 [4.55%]; P =0.02), and no longer had significantly more falls (27 [4.21%] versus 15 [2.35%]; P =0.08), bone fractures (23 [3.58%] versus 11 [1.72%]; P =0.05), or seizures (11 [1.71%] versus 8 [1.25%]; P =0.64) at 12 months. Conclusions: Fluoxetine 20 mg daily for 6 months after acute stroke had no delayed or sustained effect on functional outcome, falls, bone fractures, or seizures at 12 months poststroke. The lower rate of recurrent ischemic stroke in the fluoxetine group is most likely a chance finding. REGISTRATION: URL: http://www.anzctr.org.au/ ; Unique identifier: ACTRN12611000774921